HomeMy WebLinkAboutJirkovsky - 433 NettlesDESIGNER/ENGINEER: _ Not Applicable
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FEE SIMPLE TITLE HOLDER:
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MORTGAGE COMPANY:
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OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
L County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
th ender or an attornev before commencing work or recsrdine vour Notice of Commencement.
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/Licen4 Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF ft->, -c;,wNc ,i
COUNTY OF F.;,,y vickrA
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
X Physical Pre ence or Online Notarization
X/ Physical Presence or
Online Notarization
this I day of IC K-__ ' .i 2020 by
this I day of
2020 by
Name of person making statement.
Name of person making statement.
Personally Known P OR Produced Identification
Personally Known A3 OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
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(Signature of Notary Public- St
4PP�PUy �i LAURIE PHIL
re of Notary Public- S
ttf ri a LAURIE PHILL
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February 01,2021
REVIEWS
FRONT
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SUPERVISOR
PL
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
LLF1L- .0 ;
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential x
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Electrical - New RV Panel
Address: 433 Nettles Blvd, Jensen Beach, FL 34957
Property Tax ID #: 4502-501-0619-000-3
Site Plan Name:
Project Name: Jirkovsky Residence
Remove existing pedestal, build rack and install new RV panel.
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters
x Electric _Plumbing _Sprinklers Generator
Total Sq. Ft of Construction:
Cost of Construction: $ 1698.00
Name William M Jirkovsky
Address: 433 Nettles Blvd
Sq. Ft. of First Floor:
Lot No.
Block No.
Windows/Doors Pond
Roof Pitch
Utilities: —Sewer _Septic Building Height:
City: Jensen Beach State: _
Zip Code: 34957 Fax:
Phone No. (708) 305-2782
E-Mail: billcinj@comcast.net
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: Donald Green
Company: Don Green Electric
Address: 1305 W 1 st St
City: Fort Pierce State: FL
Zip Code: 34982 Fax: _
Phone No (772) 418-5739
E-Mail permits@dongreenelectric.com
State or County License EC13007447
11 Valuc u1 wnxruUuon is zDuu or more, a KtLUKUtU Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.